Abstract
Introduction/aims
Carpal tunnel decompression is common at the world's largest lamb processing plant. The purpose of this study was to establish whether lamb boning caused carpal tunnel syndrome, whether expeditious rehabilitation was possible and current New Zealand Orthopaedic practice.
Method
The incidences/relative risks of carpal tunnel syndrome were calculated. Kaplan-Meier survival analysis was performed examining six seasons. Comparison with a standard idiopathic population was performed. Retrospective review of five seasons established rate of return to work/complications using an accelerated rehabilitation programme. A prospective study qualified pre/postoperative symptoms using validated techniques. An email survey of the NZOA was also performed. Medical statistician advice was provided throughout.
Results
Median five-year survival for a lamb boner's carpal tunnel was 44%; boners were 120% more likely to need decompression than non-knife hands (p<0.01). The incidence of carpal tunnel syndrome in lamb boners was 10% (person-seasons): twice that of non-knife hands. This population is entirely different to the published idiopathic population (female, mean age 55). In both retrospective and prospective cohorts, postoperative return to work was 28 days: more rapid than NZOA practice. Rapid return did not cause further absenteeism nor high complication rates. There were no failed decompressions.
Conclusions
This study provides good evidence that carpal tunnel syndrome can be occupational. Our unique population has allowed a culture to develop whereby early postoperative return to is expected. This culture, good patient education and coordinated efforts at all levels of the care pathway is necessary for this level of achievement.
Declaration
In relation to the conduct of this study, no funding has been received from any source to support the cost of this study.
